The Soapbox: Chelsea Manning Has The Right To Healthcare In Prison, Transgender Or Not

Now that Chelsea Manning has expressed a desire to medically transition through hormone replacement therapy, there are a lot of questions circling about what Leavenworth looks like for a trans woman, and how exactly someone might transition from male to female in prison. While Manning’s case itself is complicated, the question of what kind of healthcare someone deserves in prison is fairly simple. There are clear legal and moral arguments for Manning receiving hormones once they are prescribed by a doctor. This isn’t about what she did or did not do; it’s about the basic commitment we make as a society when we lock someone up.

When someone commits a crime, no matter how heinous, we still have an obligation as a society to provide their basic needs while they serve their time. As Lesley Kinzel argued when writing about the Michelle Kosilek case last year, “What makes us better than murderers is that we value human life, even the lives of those who don’t value life themselves, their own included.” Whether or not you agree with Manning’s release of classified information, we consider a decent life a collective value, enshrined in the basic rights that are guaranteed by our Constitution. Courts have already held that the 8th Amendment’s prohibition on cruel and unusual punishment confers a right to adequate medical care in prison, and medical experts and courts have consistently found that hormone therapy is a medically necessary treatment for transgender people for whom it’s prescribed.

Beyond the legal argument, though, there is a moral argument in play. We recognize that prisons are overstepping the line when they pressure women into sterilization or force women to give birth in shackles. There is a basic sense, particularly among feminists, that these violations of a woman’s reproductive rights are wrong and should be condemned. The case of hormone replacement therapy for transgender women is no different. Women who need hormone therapy to fully realize their gender identity are not asking for anything beyond the basic health care that prisons are obligated to provide. Unfortunately, prison officials don’t always understand this.

Laverne Cox’s character on “Orange Is the New Black,” Sophia Burnet, has recently highlighted this gap in understanding for audiences when she confronted a warden in a dramatic scene that involved swallowing a corgi bobblehead. Burnet told the warden that without her hormones she would experience hot flashes, sweats, sagging breasts, and body hair growth. Beyond these physical effects, the mental impact of not having access to medical transition when it’s needed can be particularly severe. Trans people often experience depression (compounded by experiencing often harsh discrimination) and other mental health problems. Most shocking, 41 percent of respondents to the National Transgender Discrimination Survey reported having attempted suicide. Just as reproductive choice is an issue of freedom for all women, self-actualization through taking necessary transition steps is an issue of freedom for trans women. Hormones are, for many women, a part of that process.

We don’t know exactly what treatments Chelsea Manning will request once incarcerated, nor how the military prison system will respond. But on a larger scale, the silver lining to this case is the opportunity to spotlight in real life, as “Orange Is the New Black” has through fiction, the desperate situation many transgender prisoners face. Things are getting better, as more and more courts acknowledge the importance of transition-related care for prisoners, but many average people who rally for women’s rights and other issues are unaware of this problem. It’s time to acknowledge that health care for trans people is a fundamental right that deserves attention and immediate action. As one court boldly claimed, denying necessary medical care such as hormone treatment is a form of torture — not an American value.